Inpatient Nursing Discharge

Inpatient — Nursing Discharge

Nursing discharge is stage 4 of the inpatient discharge process. It is performed by nursing staff to formally confirm that the patient has been prepared for departure: all rooms are cleared, discharge medications have been explained, and any pending pharmacy requests have been resolved. Once confirmed, nursing discharge is required before the final bill (or any interim bill settlement) can be processed.

Page: Admission Profile → Clinical Data → Nursing Discharge, or Nursing Workbench → Clinical Data → Nursing Discharge
XHTML: /inward/inward_nursing_discharge.xhtml
Controller: NursingDischargeController
Privilege: InwardNursingDischarge
Fields on PatientEncounter: nursingDischarged (Boolean), nursingDischargeDateTime (Date), nursingDischargedBy (WebUser)

---

Discharge Flow Overview

The five-stage discharge sequence is:

Stage	Who	Action
1 — Clinical Discharge	Doctor	Records that the patient is medically fit to leave
2 — Room Discharge	Nurse/Ward	Clears the patient from the room; room returns to vacant
3 — Nursing Discharge	Nurse	Confirms readiness: rooms cleared, meds explained, pharmacy resolved
4 — Administrative Discharge	Billing	Settles the final bill; closes the admission financially
5 — Physical Discharge	Nurse	Records the moment the patient physically leaves the hospital

Nursing discharge sits between room clearance and billing. It acts as the authoritative checkpoint before the money side closes.

---

Prerequisites

Before nursing discharge can be confirmed, the system enforces:

1. Room discharge completed — patientEncounter.roomDischargeDateTime must not be null. If the patient still has an active room, nursing discharge is blocked.
2. No pending pharmacy items — any outstanding BHT pharmacy requests must be dispensed, returned, or cancelled. The page shows a list of blocking items if any exist.

---

Confirming Nursing Discharge

1. Navigate to the Nursing Discharge page from the Admission Profile or Nursing Workbench.
2. If prerequisites are not met, the page shows the blocking reason (active room or pending pharmacy items).
3. If all checks pass, click Confirm Nursing Discharge.

On success:

• patientEncounter.nursingDischarged = true
• patientEncounter.nursingDischargeDateTime = current timestamp
• patientEncounter.nursingDischargedBy = logged-in user
• A notification is raised (NursingDischarge notification type)

The Admission Profile button for Nursing Discharge turns green.

---

Cancelling Nursing Discharge

If nursing discharge was confirmed in error it can be reversed — but only if physical discharge has not yet been confirmed. Click Cancel Nursing Discharge on the same page. The three fields are cleared and billing is re-blocked.

---

Effect on Billing

From PR #21553, the bill settlement gate (BhtSummeryController.checkDischargeTime()) was changed:

Before	After
Checked that all previous rooms were individually discharged	Checks isNursingDischarged()
Compared bill time against room discharge time	Compares bill time against nursingDischargeDateTime

What this means for staff:

• Attempting to settle an interim or final bill before nursing discharge is confirmed produces the error: "Nursing discharge must be completed before the bill can be settled."
• If the bill discharge time is set earlier than the nursing discharge time, the error is: "Discharge time must be on or after the nursing discharge time."
• Once nursing discharge is confirmed and the time is valid, billing proceeds normally.

This applies to admission types where room charges are enabled. Day-case admissions (no room charges) bypass this check and can be billed without a nursing discharge step.

---

Related Articles

• Inpatient EHR — Clinical Discharge — stage 1, precedes room discharge
• Inpatient — Room Discharge — stage 2, must be done before nursing discharge
• Inpatient — Final Bill Generation — stage 4, unlocked by nursing discharge
• Inpatient — Nursing Workbench — quick access panel for nursing staff
• Admin — Inpatient Privileges and Access — InwardNursingDischarge privilege